Myasthenia Gravis Meds

Question 1

What is Myasthenia Gravis?

Answer 1

Its an Autoimmune disease that attacks the Acetylcholine receptors on the Skeletal muscle

Question 2

What are the effects of Myasthenia Gravis?

Answer 2

1) Decreases stimulation
2) Damage to the skeletal muscle

Question 3

What are the Signs and Symptoms of Myasthenia Gravis?

Answer 3

1) Double Vision (Diplopia)
2) Droopy Eyelids (Ptosis)
3) Skeletal muscle weakness
4) Difficulty swallowing.

Question 4

Signs & Symptoms of Myasthenia Crisis

Answer 4

1) Extrem Skeletal muscle weakness
2) May stop breathing

Question 5

Myasthenia Gravis worsens in the______________?

Answer 5

Evenings

Question 6

Myasthenia Gravis is better in the______________?

Answer 6

Mornings

Question 7

What are the two major types of medication for Myasthenia Gravis?

Answer 7

1) Cholinesterase Inhibitors
2) Immunosuppressive drugs

Question 8

What are the two types of Cholinesterase drugs that treat Myasthenia Gravis?

Answer 8

1) Neostigmine
2) Pyridostigmine

Question 9

Acetylcholine is responsible for?

Answer 9

Muscle Contraction

Question 10

How do the Cholinesterase inhibitors work?

Answer 10

• The motor neuron release acetylcholine, causing the skeletal muscles contraction. After acetylcholine is released, an enzyme called Cholinesterase quickly breaks down the Neurotransmitter.
• Cholinesterase inhibitors temporarily bind to Cholinesterase, slowing it down.causing the levels of acetylcholine to increase, hence producing strong muscle contraction.

Question 11

How do the Cholinesterase Inhibitors affect the acetylcholine levels?

Answer 11

• They cause the Acetylcholine levels to increase.

(This causes a production of stronger muscle contractions.)

Question 12

What are the High yield concepts of Cholinesterase inhibitor meds?

Answer 12

1) Difficulty Swallowing
2) Dose Adjustment
3) Acute Toxicity (Cholinergic Crisis)
4) Antidote (Atropine)

Question 13

What should the Nurse assess first before giving a PO Cholinesterase inhibitors to a patient?

Answer 13

• Their Swallowing Ability

(Ask the Pt to take a few sips of water in order to assess the swallowing ability. if they cant swallow notify the provider and request for an IV order)

Question 14

What is the Antidote of Cholinergic Crisis?

Answer 14

Atropine (IV)

Question 15

Myasthenia Gravis patients should be encouraged to wear a_____________?

Answer 15

Medic Alert Bracelet
(Since both the disease and the medication can be fatal)

Question 16

Signs of Cholinergic Crisis

Answer 16

(SLUDGE,BBB) mnemonic

• Salivation
• Lacrimation (excess tearing)
• Urination
• Diaphoresis / Diarrhea
• GI cramps
• Emesis (vomiting)
• Bradycardia
• Bronchospasm
• Bronchorrhea (lots of watery sputum)

Question 17

Signs of Anticholinergic Effects

Answer 17

• Can’t See
• Can’t Spit
• Can’t Pee
• Can’t Defecate
• Drowsiness

Question 18

Signs of Under-medication of Cholinesterase inhibitors / Acetylcholin?

Answer 18

1) Ptosis (Droopy eyelids)
2) Difficulty swallowing

Question 19

Signs of Over-medication of Cholinesterase inhibitors / Acetylcholin?

Answer 19

• Excessive Salivation

Question 20

What enzyme is responsible for breaks down Acetylcholine?

Answer 20

• Cholinesterase

Question 21

What does a Cholinesterase inhibitor medication do?

Answer 21

It binds the Cholinesterase enzyme (causing it to not breakdown the Acetylcholine) hence causing the levels of Acetylcholine to increase.